Protecting the most vulnerable

Jesse Jones, 4, has severe atopic dermatitis, which makes him susceptible to infections. Photo courtesy of the Jones family

When 4-year-old Jesse Jones was asked if he is scared of the “invisible virus,” he did not hesitate.

“Yes,” he said.

“We’ve been talking a lot about why we can’t do things like we normally do,” said Jesse’s mother Nicole Jones, who lives with her family in Aston Township. “We’re talking with him about the invisible virus that’s making people sick right now, and how we have to stay home and away from other people so we can stay healthy.”

For the past year, Jesse Jones has been on a number of chemotherapy medications to suppress his immune system. He was diagnosed with severe atopic dermatitis, which led to multiple health problems. Immunosuppressive drugs are the best course of treatment for him, which puts him at risk for infections caused by viruses.

“I don’t worry so much about the virus,” Nicole Jones explained. “I worry about other people’s irresponsibility. I feel like you definitely need to do more to keep people healthy, especially people like Jesse, so I’m more careful about washing my hands, touching things and taking off my jacket as soon as I come home.”

The Jones family’s concerns are not unwarranted.

Jesse and his family are among millions of immunocompromised Americans who depend on others to practice social distancing because they are at a higher risk of getting the novel virus COVID-19.

Jesse, 4, with his parents, Nicole and Barry Jones. Photo courtesy of the Jones family

According to the National Cancer Institute, immunocompromised is defined as “having a weakened immune system.”

In a 2016 journal article written by Laura H. Khan for the Bulletin of the Atomic Scientists, an organization that equips the public, policymakers, and scientists with the information needed to reduce man-made threats, Kahn estimates that there are 10 million immunocompromised people (3.6 percent of the population) living in the United States.

According to Khan, this number is underestimated because it only includes those with HIV/AIDS (both diagnosed and undiagnosed), organ transplant recipients, and cancer patients; this number does not take into consideration the large percentage of the population that takes immunosuppressive drugs for other disorders.

COVID-19 is more serious than the seasonal flu in a lot of ways. Unlike the flu, there is no known treatment or vaccine for COVID-19. The overall case fatality rate may be 1 to 2 percent, which is 10 to 20 times higher than that of the flu, according to infectious disease experts.

Data from Chinese CDC Weekly suggests that the severity of COVID-19 increases dramatically with older age and for those with underlying health conditions, which includes immunosuppression. The death rate for infected patients in their 80s was about 15 percent, as stated in the study.

The only guaranteed way to keep immunocompromised Americans safe and to prevent the spread of COVID-19 is to stay home and practice social distancing, according to experts.

The CDC defines social distancing as it applies to COVID-19 as “remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible.”

It’s particularly important to maintain that same 6-foot distance from anyone who is demonstrating signs of COVID-19, including coughing, sore throat, and fever.

With COVID-19, the goal of social distancing right now is to slow down the virus outbreaks among at risk demographics and to reduce the burden on health care systems and workers.

Experts describe this as “flattening the curve,” which generally refers to the potential success of social distancing measures to prevent surges in cases that could overwhelm health care systems, according to doctors and scientists at Johns Hopkins University.

Doctors Jeff Martin and George Rutherford III, epidemiologists at University of California, San Francisco, explained to author Nina Bai in a USC medical article for how social distancing is currently the most important activity people can do to help combat the COVID-19 outbreak, and is therefore critical.

Martin pointed out that anyone who becomes infected can spread the virus to an older person or someone who is immunocompromised.

According to experts, many people can have COVID-19 and pass it on to at-risk groups without even knowing they’re carrying the virus. This is called being asymptomatic, or not having symptoms.

“People aren’t asked to do this to protect themselves,” Martin explained. “It’s really to protect those who are most susceptible.”

“People need to understand that this is really, really serious,” Rutherford said. “It’s up to you to not get infected and to not infect others. Prevent infection by staying in your house, washing your hands, avoiding people who are sick. Society needs your help.”

According to President Donald Trump’s Coronavirus Guidelines for America, everyone should avoid social gatherings of more than 10 people, and avoid eating or drinking at bars, restaurants, and food courts. If someone in one’s household has tested positive for COVID-19, it is recommended to keep the entire household at home.

National health officials have said that the main fear now is that a sudden surge in patients needing medical care will overload the American healthcare system.

Evidence of this is already happening, with multiple states in America short on personal protective equipment, N95 masks, and ventilators. According to the New York City Department of Health, 106,813 people have tested positive for Covid-19; 29, 335 were hospitalized, and 6,182 have died.

In Pennsylvania, 24, 199 have tested positive, and 524 have died, the Pennsylvania Department of Health reports, as of April 13.

“If the outbreak is unchecked, if we did nothing, you would see a rapid escalation of infections, and that peak is what overwhelms health care systems,” Martin said.

Today, the Jones family is still prioritizing Jesse’s health by taking extra precautions to avoid exposing him to any viruses. They are self-quarantining due to the mandatory “stay-in-place” order put into effect for multiple counties in Pennsylvania by the state’s governor, Tom Wolf.

Jesse gives his mother, Nicole Jones, a hug. Photo courtesy of the Jones family

Given their mandatory free time, the Jones family is spending their time trying to find fun and safe ways to help Jesse use up energy.

“On nice days he sits right outside on the front walkway,” Nicole Jones said. “He plays with cars, enjoying being outside, or playing with dirt.”

But this is much harder to do on rainy days, Nicole Jones admitted.

“On rainy days, he’s full of energy and there’s nowhere to spend it,” she added. “He runs, he jumps, he bounces off the walls.”

Nicole Jones also has a message for people not practicing social distancing: “I’m not hypocritical. I get that, you know, people feel that they’re invincible. But we don’t live on this planet alone. If there’s any time to think about somebody else, it’s now. I feel like people just need to be aware of something greater than themselves. And unfortunately, it’s going to be hard for people to do because we live in a self-centered time.”